Evidence map›Paper›PMID 36434262›Full record

Observational studyJournal of nephrology2023

Risk improvement and adverse kidney outcomes in patients with chronic kidney disease: findings from KNOW-CKD.

Hee Byung Koh, Hyung Woo Kim, Chan-Young Jung, Yaeji Lee, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Joongyub Lee, Yeong Hoon Kim, Dong-Wan Chae and 4 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 81% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 1 country.

Hee Byung KohDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Hyung Woo KimDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Chan-Young JungDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Yaeji LeeDepartment of Biostatistics and Computing, Yonsei University College of Medicine, Seoul, Korea.
Jung Tak ParkDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Tae-Hyun YooDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Shin-Wook KangDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
Joongyub LeeDepartment of Prevention and Management, School of Medicine, Inha University, Incheon, Republic of Korea.
Yeong Hoon KimDepartment of Nephrology, College of Medicine, Inje University, Busan, Republic of Korea.
Dong-Wan ChaeDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Woo Kyung ChungDepartment of Internal Medicine, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Kook-Hwan OhDepartment of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Seung Hyeok HanDepartment of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea. hansh@yuhs.ac.ORCID http://orcid.org/0000-0001-7923-5635
KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD) Investigators
Yonsei University · KRGachon University Gil Medical Center · KRInha University · KRInje University · KRSeoul National University Bundang Hospital · KRSeoul National University Hospital · KR

Funding

Korea Centers for Disease Control and Prevention 2011E3300300Korea Centers for Disease Control and Prevention 2012E3301100Korea Centers for Disease Control and Prevention 2013E3301600Korea Centers for Disease Control and Prevention 2013E3301601Korea Centers for Disease Control and Prevention 2013E3301602Korea Centers for Disease Control and Prevention 2016E3300200Korea Centers for Disease Control and Prevention 2016E3300201Korea Centers for Disease Control and Prevention 2016E3300202Korea Centers for Disease Control and Prevention 2019E320100Korea Centers for Disease Control and Prevention 2019E320101Korea Centers for Disease Control and Prevention 2019E320102Korea Centers for Disease Control and Prevention 2022-11-007
6 · The paper itself

Abstract

backgroundMany trials have attempted to slow the progression of chronic kidney disease (CKD) by modifying specific risk factors, but without achieving satisfactory results. We aimed to evaluate the association between the degree of improvement in multiple risk factors and adverse kidney outcomes.

methodsThis was a prospective observational study of 839 patients with CKD G3-G4. The main predictors were the number of improved risk factors between baseline and year one as follows: a decrease in proteinuria, systolic blood pressure, phosphate, and uric acid, and an increase in hemoglobin and bicarbonate from the baseline status to out of the target range. The primary outcome was a composite one, including CKD progression (50% decline in eGFR or kidney replacement therapy) and all-cause death.

resultsPatients whose risk factors eventually improved had more unfavorable baseline profiles of the six considered factors. During 3097.8 person-years of follow-up (median 3.5 years per patient), the composite outcome occurred in 48.0% of patients (incidence rate, 13.0 per 100 person-years). Compared with an improvement of no risk factors, the adjusted HRs (95% CI) for improvement of 1 and ≥ 2 risk factors were 0.96 (0.76-1.22) and 0.53 (0.37-0.75), respectively. The association was not affected by diabetic status or CKD severity. Among the risk factors, proteinuria accounted for the greatest contribution to CKD progression.

conclusionsIn patients with CKD G3-G4, improvement in multiple factors was associated with a decreased risk of CKD progression, suggesting the importance of multifactorial risk management.

Indexed as

Renal Insufficiency, ChronicDisease ProgressionHumansKidneyProteinuriaRenal Replacement TherapyChronic kidney diseaseMultifactorial approachRisk factor

Identifiers

PMID36434262
OpenAlexW4310079127

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.